Policy Harbour's Group Health Insurance

Advantages of Employee Group Health Insurance

• Infant Coverage from Day 1:

  The newborn baby of the employee receives coverage from the day of their delivery.

• No Waiting Period:

  When compared to individual health plans, group health insurance plans do not impose a waiting time for the designated illnesses.

• No Medical Screening:

  The employee can begin receiving group health insurance benefits immediately without having to pass any form of medical screening.

• Pre & Post-Hospitalisation Coverage:

  Pre- and post-hospitalization expenses are covered under the group mediclaim policy for employees.

• Easy Claims:

  Employees with group mediclaim insurance policies find the claims process easier and more convenient. (Condition: Claim settlements for employees visiting network hospitals can be obtained without requiring monetary transactions. In the event that the worker does not go to a network hospital, they will be responsible for covering the cost of care and filing a claim for reimbursement within the time range that the insurance company specifies.

• Cashless Claim:

  In 45–60 minutes, cashless claims can be completed if the insured worker receives medical attention at a network hospital.

• Reimbursement Claim:

  In the event that the insured worker receives treatment at a hospital outside of the network, reimbursement claims may be filed within 15 working days.

What Does a Group Health Insurance Policy Cover?

A group health coverage plan usually covers you for the following:

• Choice to include children or a spouse, etc.

• Benefits of cashless hospitalization at network hospitals

• Maternity costs are also covered by certain insurers.

• No need for a medical examination

• Daycare protocols

• Pre-hospitalization and post-discharge costs

• Emergency ambulance costs

• Hospitalization costs for inpatients

• Chronic conditions such as diabetes, arthritis, etc.

• Pre-existing sickness coverage

What does a Family Health Insurance Plan generally not cover?

When purchasing health insurance for your family, it's essential to carefully review the policy documents to comprehend the exclusions thoroughly. Additionally, it's important to check the waiting periods outlined in the policy. Typically, family health insurance plans in India do not cover the following medical expenses:

• Outpatient treatments and routine medical check-ups

• Expenses incurred on any aesthetic treatment or plastic surgeries

• Expenses incurred on life-support machines

• Treatment that was taken overseas unless it is included in the plan

• Any illness or injury resulting due to war conditions, nuclear reaction, rebellion, acts of foreign enemies, etc.

• Injury or illness due to participation in unethical or criminal activities

• Pregnancy or childbirth-related complications (unless mentioned in the plan) like voluntary termination of pregnancy, miscarriage or abortion, etc.

• Any pre-existing medical condition is not covered until the completion of the waiting period

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